As a global purchaser of healthcare for its employees, IBM is taking an active role in healthcare transformation in ways that not only promote reform, but also bring benefits and lower costs to IBM employees.
The centerpiece of IBM's healthcare strategy is to encourage wellness. By using incentives for wellness activities to encourage and reward healthy behavior, IBM's programs foster a culture of physical activity while providing tools to assess and invigorate health improvements. In 2005, nearly 90,000 IBM employees completed our Health Risk Assessment, while employees earning IBM's physical activity rebate increased by 21 percent.
IBM's electronic personal health record and other Web-based tools make it easier for employees to do and track wellness activities. Employees can enter and store their personal medical information in one place as well as use online tools to assess health risks, evaluate symptoms and track doctor visits.
IBM also offers a program to help employees with chronic illnesses, providing medical evaluations and follow-up consultations to drive health improvements for these patients.
In addition to wellness programs, IBM uses financial incentives to shape the way medical care is delivered to employees. IBM uses value-based purchasing, including offering incentives to providers that re-engineer their practices and adopt information technology, and rewards physicians who have been recognized for providing high-quality care.
Perhaps the most important path to improving healthcare is patient-centric primary care, where each patient has an ongoing relationship with his or her primary care physician, who can function as an advocate, care integrator and facilitator for access to care for patients and is paid to do so. To encourage this relationship, IBM offers free preventive care with a focus on the primary care physician.
IBM's initiative, called "Primary Care that Matters," stems from the fact that primary care by general practitioners, family practice and general internists whom patients know and trust has gradually given way to an era of specialists. The decline of primary care is a neglected but important root cause of many problems in the healthcare delivery system, particularly in the United States. IBM has a stake in changing this by improving the frequency and quality of interactions between patients and their primary care providers.
This is not a gatekeeper, as in past models, but a "medical home" for patients, where they can be seen in a timely fashion by a personal physician who has a comprehensive understanding of the patient's physical and emotional needs and specific preferences. The personal physician becomes the primary partner in the patient's care, while coordinating and facilitating interactions with other care practitioners, specialists or sub-specialists. Research shows that patient-centered primary care results in better health outcomes, lower costs and greater equity in access to healthcare.
Reviving primary care includes supporting primary care doctors with technology that enables them to fulfill this role more effectively. For example, IBM is participating in Bridges to Excellence, a not-for-profit effort to encourage a more uniform and efficient level of primary care by rewarding providers who follow best practices from the National Committee for Quality Assurance.
In Georgia, IBM and 14 other employers pay physicians an extra fee for every diabetic patient covered under those companies' insurance plans if the physicians follow guidelines for diabetes care and use electronic medical records systems that help implement the guidelines and improve efficiency. IBM also participates in a Bridges to Excellence program in the Boston area that includes diabetes treatment, cardiac care and physician practice re-engineering based on information technology.
These programs are just the beginning of a comprehensive shift to primary care. Ultimately, each patient will have a "medical home" where he or she will receive comprehensive and continuous care from primary care practitioners and complete medical information based on electronic health records. A networked healthcare industry will permit exchange and access to information among doctors, hospitals, pharmacies and insurers. This has tremendous potential for reducing costs and improving the quality of care.
If a patient's complete health records are stored electronically, for example, a new prescription could be checked automatically against allergies or for interactions with other drugs already being taken. Likewise, connecting healthcare providers with an information network creates further safeguards. Instant transmission of test results from a laboratory to a doctor, for example, can save critical time in making a diagnosis and starting treatment, as well as reducing the number and cost of duplicate tests.
Systems like this already exist in countries like Denmark and Singapore, but wider adoption will take time, effort and considerable investment. Meanwhile, IBM is already finding opportunities to make this vision of connected healthcare a reality for our employees around the globe.